2019 NOA Distinguished Service Award Nomination

Distinguished Service Award: Persons nominated for this award shall be optometrists, members of the Nebraska Optometric Association, who, over a span of years, have rendered outstanding and exemplary service to their community and profession, and who have distinguished themselves as exemplary citizens and optometrists of the state of Nebraska. Click here to view a list of previous recipients.

The award will be presented at the NOA Fall Convention and the recipient will be notified in advance.

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* Nominee's Information:

Name of Nominee:

Practice:

Address:

City/Town:

State:

ZIP:

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* Why do you feel this nominee deserves this award?

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* Person submitting nomination:

Name:

Email Address:

Phone Number: